Integrated teleconferencing system

ABSTRACT

A method provides supervision to a includes providing a plurality of information channels for communicating information to the service provider and the user and integrating the information channels to provide access to supervisory functionality for supervising the information channels of the plurality of information channels by way of a single portal. The method provides access to audio/visual functionality, to information record functionality, to diagnostic functionality, to action functionality and to administrative functionality. All functionalities are accessed by way of a portal whereby the portal has access to the functionalities simultaneously. A single accessing of the portal by the user permits the user to gain access to all of the functionalities simultaneously in accordance with the single accessing. The portal can be a web portal. Each of the functionalities is access by way of a respective information channel of a plurality of information channels.

BACKGROUND OF THE INVENTION

1. FIELD OF INVENTION

The present invention is directed to a method and system forteleconferencing to permit a service provider to provide a service to auser at a remote location.

2. DESCRIPTION OF RELATED ART

The field of providing services from a service provider to users atlocations remote from the location of the service provider by way oftelecommunications systems such as the internet is a large and growingfield. Using telecommunications systems in this manner allows theservice provider and the user to interact easily from any distance atalmost any time. Very importantly, systems such as these could permitunlimited resources to be applied to the interaction.

An important example of the fields of art where service providers canprovide their services to users at remote locations is the health careindustry. Recent research has established that the health care industrywill achieve approximately $370 billion in online transactions by 2004,according to a report from Forrester Research. This report, entitled“Sizing Health Care E-Commerce,” predicts that the Internet will becomethe foundation for a new health care industry infrastructure supportingcomplex, multiparty transactions among consumers, providers, insurersand medical suppliers. With 31% of online consumers already shopping forhealth care products on the web, online health sales and usage show nosign of slowing. There has already been a well documented growth andproliferation of online websites and medical related portals. Thewebsites WebMD.com and DRKoop.com are examples of only two of the manysuch websites and portals.

Further, “Cyber Citizen Health”, an ongoing program of researchconducted by Cyber Dialogue published a study indicating that 22.3percent of all adults online rely on the internet for healthinformation. This study also found that 18 percent of the adult studiedare inclined to purchase over the counter drugs online. Additionally, 23percent of the adults studied purchase vitamins and supplements online.Other medical supplies online are purchased by 20 percent of the adultsstudied.

Similarly, a recent Healtheon Corp Internet survey of the field revealedthat 85 percent of physicians are currently using the internet, a markedincrease of regular online activity by physicians. This surveychronicled the computer needs and expectations of almost 10,000physicians. The survey found that more than 63 percent of the physicianssurveyed use email daily and that 33 percent have used email tocommunicate with patients.

Doctor-patient communication via email has jumped 200 percent in arecent twelve month period and nearly 20 percent in a recent three monthperiod. Electronic communications between patients and doctors wasstatistically insignificant when physicians were first surveyed in 1997.

Many references teach the use of telecommunications to provide services.For example, U.S. Pat. No. 5,434,611 issued to Tamura (Tamura) on Jul.18, 1995 teaches the use of a cable system for bidirectionalaudio/visual communication and transmission of data including dataobtained from monitoring equipment. Alternately, a system taught in U.S.Pat. No. 5,441,047 issued to David et al. (David) on Aug. 15, 1995 canbe provided with separate transmission of monitored physiological dataover a telephone line rather than a cable system.

Another reference teaching remote monitoring of physiological parametersand transmission of physiological data to a medical care worker orexpert system at a remote patient location during a remote consultationis U.S. Pat. No. 6,046,761 issued to Echerer on Apr. 4, 2000. Additionalreferences teaching such transmissions include U.S. Pat. No. 6,731,324issued to Levy on Apr. 4, 2000, U.S. Pat. No. 5,462,051 issued to Okaet. al. (Oka) on Oct. 31, 1995 and U.S. Pat. No. 6,804,656 issued toRosenfeld et al. (Rosenfeld) on Oct. 12, 2004.

Additionally, access to a database, emergency services, a specialist, orambulances during remote consultations is taught. See for example,David, U.S. Pat. No. 6,638,218 issued to Bulat on Oct. 28, 2003, U.S.Pat. No. 6,731,324 issued to Levy on May 4, 2004 and U.S. Pat. No.5,619,991 issued to Sloane (Sloane) on Apr. 15, 1997. Furthermore,Rosenfeld teaches monitoring patient rooms from a remote location havingaccess to a number of different databases for improving the care of thepatients.

Additionally, Oka teaches a medical worker transmitting instructions inresponse to information received from the remote location in such asystem. Bulat teaches transmitting a prescription to a pharmacy inresponse to a consultation in such a telecommunications system. A singlechannel is used for transmitting the monitored physiological data fromthe patient to the health care worker in Oka. Additionally, the use ofmultiple channels for transmitting the parameters is taught. Forexample, Bulat teaches providing a physician with an audio/visual linkto a remote patient terminal by way of a telephone system, as well aslinks to patient, medication and protocol databases by way of a LAN.

The use of a remote consultation system to perform billing and paymenttransactions is also known. For example, Bulat teaches collecting creditcard and insurance information in a remote consultation system. Echererteaches providing an itemized bill, forwarding the bill to the patientby facsimile and accepting payment within the remote consultation systemby means of a number of health management program cards.

U.S. Pat. No. 5,434,611 issued to Tamura on Jul. 18, 1995 is directed toa home health care system that uses a two way community antennatelevision network to permit remote communication between doctors andpatients. Similarly, U.S. Pat. No. 5,619,991 issued to Sloane on Apr.15, 1997 is directed to a system that facilitates the delivery ofmedical services using electronic data transmission. U.S. Pat. No.5,748,907 issued to Crane on May 5, 1998 discloses an interactivereal-time medical management system that can control many aspects of amedical practice.

Moreover, U.S. Pat. No. 5,987,510 issued to Imai, et. al. (Imai) on Nov.11, 1999 is directed to a packet based telemedicine system forcommunicating video, voice and medical data between a central monitoringstation and a patient monitoring station. The patient monitoring stationobtains digital video, voice and medical measurement data from a patientand encapsulates the data in packets and sends the packets over anetwork to a central monitoring station. Since the information isencapsulated in packets in the Imai system, the information can be sentover multiple types of network architectures or combinations of networkarchitectures. The video, voice and measurement data in the lmai systemcan be integrated and sent over a single network.

Similarly, David discloses an ambulatory patient health monitoringsystem for monitoring a remotely located healthcare patient from acentral station. The David system includes instruments for measuringparameters of the medical condition of the patient such as heart rate,respiratory rate, pulse and blood pressure. The David system includes afirst audio/visual camera disposed at the patient location and a secondaudio/visual camera disposed at the central station. The audio and videoinformation obtained in this manner is transmitted between the patient'sremote location and the central station via a communications network.

However, the David system is not network independent because the systemdata must be formatted in accordance with a different communicationsprotocol for each of the different networks. Although the systemdisclosed in the David reference can send information between thehealthcare worker and the patient via various types of networks, theinformation must be reformatted in different ways in order to becorrectly used. Another disadvantage of the David system is that theaudio and video data are sent over one communication network and thepatient data is sent over another communication network.

U.S. Pat. No. 5,924,074 issued to Evans (Evans) on Jul. 13, 1999discloses streaming compressed digital hypervideo received upon adigital communications network being. The compressed hyper-video isdecoded and played in a client computer based video on a web VCRsoftware system. Up to twenty-one past scenes can be displayed asthumbnail images within the system taught by Evans. Hyperlinks withinthe main video scene, and/or any of the thumbnail images, can be shownas hot spots, with text annotations typically appearing upon a cursormouse over.

Thus, known systems such as the foregoing have provided valuabletechniques for allowing service providers to bring resources to bear onproviding their services to users at remote locations. However, theytypically bring resources from only one or a few different sources tobear on the interaction at a time. Furthermore, the techniques foraccessing the resources are cumbersome, and if the resources areaccessed from different sources it is necessary to make multiplecumbersome accesses in order to obtain all of different resources. Suchmultiple accesses can involve getting through several firewalls andproviding multiple sets of user identifications and passwords.

Specifically, there is a long felt need for technologies whichfacilitate the provision of information and services via a communicationnetwork. The telecommunication technologies can which can be facilitatedcan include real time interactive video or multimedia presentations. Inparticular, there is a long felt need teleconferencing for systems forproviding such information via a plurality of platforms, including awireless web, such that end users of the system can engage in aninteractive exchange of information with service providers.

There is a particular need for systems which facilitate and supervisephysician oversight and interaction with the patent. One of therecurring problems in providing health care, including remote healthcare, is that many patients fail to comply with recommendations made bytheir physicians. There is thus a long felt need for solutions whichmaintain closer interaction and monitoring between doctor and patient topermit monitoring of compliance. Additionally, it is important that sucha system enable patients to maintain the confidentiality if theirpatient records. Furthermore, such a system should permit patients tohave their risk assessments updated more frequently and provide realtime one-on-one management.

All references cited herein are incorporated herein by reference intheir entireties.

SUMMARY OF THE INVENTION

The system and method of the invention permits service providers toprovide supervised teleconferencing, such as a supervised cyber officevisit by a doctor or other health care provider, to a user located at alocation remote from the location of the service provider, such as ahome, an emergency room, a hospital or a nursing home. This permits thesystem and method of the invention to provide the advantages of advancedtechnologies, including large scale integration of the advancedtechnologies, to the remote locations. Furthermore, it permits multiplechannels transmitting multiple applications to be displayed inpredetermined location on a single graphical user interface.Accordingly, it permits sharing of data between the channels andsupervision of web services.

A method for providing supervision to a teleconference including aservice provider and a user includes providing a plurality ofinformation channels for communicating information to the serviceprovider and the user and integrating the information channels of theplurality of information channels to provide access to supervisoryfunctionality for supervising the information channels of the pluralityof information channels by way of a single portal. The method is adaptedfor providing access to audio/visual functionality by way of the singleportal, providing access to information record functionality by way ofthe single portal and providing access to diagnostic functionality byway of the portal. Access to action functionality by way of the singleportal and providing access to administrative functionality by way ofthe single portal are provided whereby the portal has access to thefunctionalities simultaneously. A single accessing of the portal by theuser permits the user to gain access to all of the functionalitiessimultaneously in accordance with the single accessing. The portal canbe a web portal. Each of the functionalities is access by way of arespective information channel of a plurality of information channels.

In another aspect of the invention a method for providing supervision toa teleconference including a service provider and a user includesproviding a plurality of information channels for communicatinginformation to the service provider and the user and integrating theinformation channels of the plurality of information channels to provideaccess to supervisory functionality for supervising the informationchannels of the plurality of information channels by way of a singleportal. The supervisory functionality includes supervision of medicalfunctionality and the record information functionality includesaccessing medical records information. The diagnostic functionalityincludes monitoring at least one medical parameter to provide amonitored medical parameter. In a further aspect of the invention thesupervisory functionality can include supervision of legalfunctionality.

In a further aspect to the invention a method for providing supervisionto a teleconference including a service provider and a user includes aportal simultaneously having access to audio/visual functionality,information record functionality, diagnostic functionality, actionfunctionality and administrative functionality. A single access of theportal by the user provides the user with access to all of thefunctionalities simultaneously in accordance with the single access. Thesingle access is in accordance with a single sign in. The portal can bea web portal. Each of the functionalities is accessed by way of arespective information channel of a plurality of information channels.

In a further aspect of the invention a method for providing supervisionto a teleconference including a service provider and a user includesproviding access to audio/visual functionality by way of a portal,providing access to information record functionality by way of the webportal and providing access to diagnostic functionality by way of theportal. Access to action functionality is provided by way of the portalaccess to administrative functionality is provided byway of the portalwherein the portal has access to the functionalities simultaneously inorder to provide supervision of the functionalities. With singleaccessing of the portal by the user whereby the user gains access to allof the functionalities simultaneously in accordance with the singleaccessing. The portal comprises a web portal.

A system for providing teleconferencing functionalities to a userincludes a portal simultaneously having access to integratedaudio/visual functionality, information record functionality, diagnosticfunctionality, action functionality and administrative functionality toprovide supervision of a teleconference. A single access of the portalby the user permits the user to gain access to all of thefunctionalities simultaneously in accordance with the single access. Thesingle access comprises a single access in accordance with a singlepassword. The portal is a web portal.

A method for providing teleconferencing functionalities to a serviceprovider and a user includes providing access to supervisoryfunctionality by way of a portal and providing access to informationrecord functionality by way of the web portal. Access to diagnosticfunctionality by way of the portal is provided and access to actionfunctionality by way of the portal is provided. Access to administrativefunctionality by way of the portal is provided wherein the portal hasaccess to the functionalities simultaneously.

The present invention is in one embodiment directed to a system forproviding two way communication network access to information for suchdiverse areas as medical information, corporate information, law,government, entertainment, fitness, elder care, educational informationand any other type of information. The invention utilizes and canincorporate a host of technologies including broad bandwidth, networkresources, optimized routing, negotiated transport, two wayvoice-recognition, audio/visual real-time one on one supervision, dataanalysis and data intelligence, real time patient vital sign recordingand clinical testing and on line examination. Compliance, prevention,evaluation, diagnosis, personalized content and clinical treatment canbe facilitated in a secure on line Internet, Internet 11 or channeleddelivery network using any type of telecommunications system. Forexample, fiber, satellite, television, cable and wireless technologiescan be used.

The present invention provides an easy to use mechanism for users suchas medical care providers and patients to obtain information, thispermitting practitioners to provide one on one care. The invention canbe utilized as part of a contracted, time based usage subscriptionservice in which utilization of bandwidth and time can form the basisfor revenue generation. The usage determination can be adjusted formedical coverage parameters.

An important feature of the invention is the provision of one on onereal time audio visual interaction between a user and a health careprovider or other person. The invention can permit providing and/orenabling and facilitating supervision including voice, image and remoteonline and wireless inquiry and examination. The invention can be usedfor instruction, education, training and communicating vital signs orother medical information. Knowledge tests can be facilitated within aproprietary secure integrated multichannel, multi portal network.Individualized users, providers and supervisors can be provided withcustomized and integrated connectivity, engineering, networking andsoftware by way of a GUI. The GUI makes it easier to move data from oneapplication to another. The GUI can have standard formats forrepresenting text and graphs. Because the formats are well defineddifferent programs can run under the common GUI and share data.Furthermore, the GUI can serve as a custom client for supervising theproviding of any type of service. Such integration and supervision ofcommunication between service provides and their clients permitsseamless intelligent software controlled access to and from multiplehigh bandwidth delivery mechanisms and devices by way of a number ofinformation channels.

The invention is designed to promote active participation of allindividuals involved in providing the remote services. For example, alllevels of the healthcare industry including patients, physicians,providers, insurance companies, managed care companies, rehabilitationand exercise facilities and government agencies involved in totalpatient well being can participate. In the medical context, for example,the present invention provides for the interactive exchange of patientdata, vital signs and status in real time during the exchange.

The present invention can incorporate a core which has extends multichannel one on one remote supervision for many different industries. Thesupervision web services of the invention can access and superviseapplications relating to any field of art. It can be advantageouslyapplied to applications in telemedicine and collaborative healthcare forremote consultation and monitoring of patients. The invention canutilize the connectivity between high bandwidth providers to form acyber superhighway that enables one on one audio/visual real timesupervision and facilitates connectivity for channeling content into aunified platform that is customized for specific target multi-industryapplications. The invention can utilize integrated connectivity to makeany content available by way of a single access to a single e-commerceportal. This important feature of the invention is provided by means ofa centralized plug in capability. This capability enables users to moldand standardize information technology and e-commerce providers into averified interaction in a simultaneous one on one real time supervisionenvironment with a single portal for access to all of the resources.

Thus, the invention can enable a cyber superhighway based a singleportal to function as a backbone template. This enables high bandwidthtechnology companies, information technology companies, and any othertype of commerce companies to maximize their valuation. In effect, theinvention can be a facilitator and supervisor to enable companies toutilize audio/visual one to one real time supervision on the internet orprivate network with their client's and customers.

As previously described, the present invention can be veryadvantageously applied to the health care industry. The presentinvention provides core functionality including supervision comprisinglive one to one audio/video supervision. The invention further providesrecords and a history associated with interaction between serviceproviders and users. In the case of medical supervision applications,electronic medical records (EMRs) showing information such as charts,doctors' notes, pre-stored audio/video streams, etc. can be provided tothe users.

The invention can include a diagnostic alerting system along in responseto monitoring using medical instrumentation. The invention can permittesting of a patient to be performed in real time during theinteraction. An action may be interfaced with partnering companies. Inthe case of medical supervision channels may be labeled as e-health andtreatment channels, thereby bringing audio/video capability betweendoctors and pharmacists for products, sales and other services. Theother services can include, but are not limited to, dietitians,therapists etc. Administrative functions, such as billing, auditing andaccounting can be performed while the supervisory sessions are inprogress thereby increasing efficiency and decreasing errors. Forexample, simultaneously users can interface with insurers who caninterface with service providers.

It is to be noted that the invention provides for multiple channelsupervision environments. In one embodiment multiple differentinformation streams including audio/video or virtual electronic recordschannels can be simultaneously available to the physician and patientsduring supervision procedures. A high speed channel within the systemcan provide supervision and contain the audio/video streams necessaryfor the live one on one supervision activities such as those involved intelemedicine applications.

A second channel can provide records and can contain personalinformation of the user in the form of electronic medical records, EMRs,etc. The information can include charts, doctors' notes, selectedportions of audio/video sessions, etc. A third channel can providediagnostics and refer to specific real time alert signals generated fromtests run simultaneously on medical instrumentation results. The signalsfrom the medical instruments can be compared to records information andaudio/visual streams stored in many other locations. A fourth channelcan provide e-health or e-treatment capability to the system andautomatically generate orders such as prescriptions. The orders can besupervised by the doctor who can review them and add an electronicsignature. The fourth channel can also interface with locations such aspharmacies and allow patients access to information about theirtreatments stored in many other locations.

A fifth channel can provide administrative and other managementfunctions needed for each interaction. For example, user billing,insurance filing and purchasing of required supplies can be permitted.Another possible feature of the administrative channel can be matchinginventories to the user's needs possible orders can be automaticallygenerated when necessary due to materials being out of supply.Interfaces with hospital administrative systems can be transparent tothe user. It is to be noted that the administrative channel scenario caninvolve any other services in addition to prescribing.

A Palm-like or other hand-held device may support a cellular phone orWLAN connections to the system and the user. In one example, a doctormay write a prescription. The system can automatically send theprescription for pre-authorization to the insurance company. The patientcan pay the normal co-payment to the insurance company or the physicianduring the telecommunication session. The Palm like device or other handheld device may be used by the doctor's staff to update the patient'selectronic medical records in real time. The structure of the inventionallows for partnering technologies, as well as links to insurancecompanies. This permits electronic filing of claims and faster insurancereimbursement to the physician or patient.

BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS

The invention will be described in conjunction with the followingdrawings in which like reference numerals designate like elements andwherein:

FIG. 1 shows a block diagram of a media broadcast suitable for use withthe present invention.

FIG. 2 shows a screenshot of a graphical user interface display blockdiagram of a prospective end user system in accordance in the presentinvention that may be presented in accordance with the presentinvention.

FIG. 3 shows block diagrams of a system in accordance with the presentinvention.

FIGS. 4, 5 show a more detailed representation of the central server anddatabase systems of the present invention.

FIG. 6 shows a graphical representation of a network backbone inaccordance with the present invention.

FIG. 7 shows a schematic representation of an alternate embodiment inaccordance with the present invention.

FIG. 8 shows a schematic representation of supervisory portalarchitecture in accordance with the present invention.

FIG. 9 shows typical information that can be integrated when the presentinvention is applied to the medical field.

FIGS. 10A, 10B show block diagram representations of graphical userinterface and a central server which can be used with the system of thepresent invention.

FIG. 11 shows an intranet connection which may be used with the systemof the present invention.

FIGS. 12A-C show an enterprise intranet connections, includingconnections to a GUI, which may be used with the system of the presentinvention.

FIG. 13 shows an alternate embodiment of an intranet connection whichmay be used with the system of the present invention.

FIG. 14 shows a block diagram representation of a certificate authoritywhich may be used with the system of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is specifically directed to a system for providingonline, interactive content and audio/video presentations and systemsbetween a service provider and a remote user of the service. In oneembodiment the end users may be doctors and patients. In otherembodiments the end users can be an attorney-client, real estatebroker-customer or any other pair of commercial users who need toprovide content and information to each other. Thus, while the presentinvention is sometimes described in the context of the provision ofmedical information and care for illustrative purposes, it is to beappreciated that the present invention is applicable to a wide array ofmarkets and applications.

Referring to FIG. 1, there is shown a proposed diagram of the system 10of the present invention. In this embodiment, the present invention canbe a dynamic content driven web application. However, it will beunderstood by those skilled in the art that any type of communicationnetwork can be used in keeping with the scope of the invention. Thepreferred embodiment can include an internet web application thatprovides a plurality of content including searchable information, FAQs,articles and chat rooms. The preferred embodiment of the invention alsohas the ability to engage in one on one real time sessions between aservice provider and a user such as a medical patient or a legal clientby way of the computer 16, for example, using the known HTTP or MMSprotocols.

When the system is applied to the field of telemedicine the patient maybe bed ridden or in a nursing home or any other location accessible viaa computer or TV module. The invention can incorporate voice recognitiontechnology to permit both physicians and patients to input data into thesystem. An important feature of the present invention is the provisionof online monitoring and examination between the service providers andthe users. Specifically, the present invention provides for andfacilitates one on one real time supervision between the serviceproviders and the end users. The content provided can be searchable bykey word or phrase. This allows end users to quickly locate informationwithin the system 10, which relates to a specific area of interest orneed the end user may have. By utilizing a database driven system, auser of the invention is able to quickly locate information on a desiredbasis.

The present invention has a number of uses and applications, includingthe ability to push updated information to users to send email notices,to enable users to continue to use the programs available from the sitewhen offline to provide content and audio video formats to enable endusers to track their own progress when using programs, to receivedynamic risk assessments and to locate health/care services andproviders.

As shown, the system 10 can include two dedicated servers 11, 13, forexample, a web server, a Microsoft Media server such as a Windows 2000server or a Real Media Server. The servers 11, 13 can run in a singlecomputer. The system 10 further incorporates video processing softwaresuch as video conference software applications and databases integratedwith streaming video systems based on solutions of the kind of the RealNetworks Digital Media Solutions products family. Thus, the system 10could support Universal Media Delivery, Modular architectures,standards-based solutions supporting RTSP, SMIL, XMCL, MPEG and majoroperating systems. The system 10 can be able to deliver rich media viaInternet-enabled devices. The system 10 also can incorporate large datastorage 19 and security for sensitive information and the informationthat may need to be accessed by various types of users. The server cancommunicate with a live encoding personal computer 12, for example,using HTTP or MS BD protocol.

The present invention can be directed to a comprehensive system forfacilitating the provision of medical and health related information,including real time audio video one-on-one interaction between an enduser and a server provider. Furthermore, it is to be appreciated thatthe present invention is applicable to any field of endeavor whereinformation is shared among end users. Non-exclusive examples includethe legal, financial services, banking, accounting and engineeringfields. It is to be appreciated that the teachings of the presentinvention are thus applicable to other fields of use and areas in whichinformation need to be shared and conveyed by and among end users. Thepresent invention can provide selectable audio/visual channels,diagnostic information and data, news, clinical information in a widearray of medical areas, training, education and eldercare, wherein it ispossible for any of the channels to transmit audio/visual information ifdesired. Furthermore, the audio/visual information may be applied to thechannels in any manner known to those skilled in the art.

In a preferred embodiment set forth herein for illustrative purposes theinvention can be practiced using five communication channels orinformation streams. However, it will be understood by those skilled inthe art that the number of channels or information streams used is notcritical, as long as they are integrated and supervised to provide aportal for permitting a provider of services to provide the services toa user at a location remote from the provider as set forth herein below.The integration of the channels permits the functionality to accessstructured and unstructured information and make it available foranalysis, editing and display.

The five channels used in the illustrative embodiment herein can be: 1)a supervision channel including the audio/visual streams to permit liveinteractive supervision activities, for example, between the provider ofthe services and the user, 2) a records channel including access topersonal information of the user or other information relevant toproviding the services, 3) a diagnostics channel including informationaccording to devices such as real time sensors or monitoring equipmentto provide alerts or permit other responses to the information availablefrom the integrated channels, 4) an action channel to permit theprovider of the services to take actions based on the informationavailable from the integrated channels and 5) an administrative channelfor providing management functions required in order to provide theservices to the user. All five channels are integrated and synchronizedand can contribute to providing the supervision of the teleconference inaccordance with the inventive system and method.

When the present invention is applied to the field of telemedicine thesupervision channel can permit live interaction between a health careworker, for example a doctor and a patient. In such an application, therecords channel can permit access to sources such as electronic medicalrecords and EMRs including information such as charts, doctors' notes,portions of previous audio/visual sessions. etc. The diagnostics channelcan be used to transmit real time alert signals generated from tests runon medical instrumentation results. The action channel can generate, forexample, a prescription for a doctor's review and an electronicsignature and can have direct access to facilities such as pharmacies.

An example of a supervision application suitable for integrating andsupervising the foregoing channels is also set for herein below.However, it will be understood that any number of differing applicationscan be provided by those skilled in the art to provide the integrationand supervision of the channels required to provide the services to auser at a remote location according the invention.

Referring now to FIG. 2, a video display interface display 25 of acomprehensive interactive system in accordance with the presentinvention is shown. The video display interface display or GUI 25 can beused to display, for example, records of consultations, hospitalrecords, diagnostics, EKGs and film images when the invention is appliedto the medical arts. The patient's treatment regimen includingpharmacology, products, services, programs and information can also bedisplayed. The display interface of the system 10 can incorporate anadministration module 23 which can provide intelligent analysis,statistical data, outcome studies, financial data and supervision.During real time one on one communication and interaction the system 10can record information such as patient history, prognosis, visithistory, treatment history, family history, drugs, chronic conditions,lab results, surgical history, radiology films, compliance history,research records, oral history, consultations and prognosis, forexample, using the server 13.

The central image of the interface display 25 can be accessed by thephysician to obtain information about the patient such as allergies andreactions. The system 10 thus creates one on one real time audio visualinteraction between the end user and the provider and enables andfacilitates supervision including voice, image and remote online &wireless inquiry, examination, instruction, education, training, vitalsigns and other medical information, knowledge tests and markers withina secure integrated multi-channel, multi-portal network such as shown inFIG. 6. The network can be individualized to patient, individual,provider and supervisor with customized and integrated connectivitydesign, engineering, networking, and software to provide seamlessintelligent software controlled access to and from multiple highbandwidth delivery mechanisms and devices.

The invention facilitates centralized access to individuals, one on one,in an interactive visual and voice online, satellite, wirelessintegrated secure environment for the purpose of providing supervisionin real time. This capability permits on line examination withconcurrent access to records, charts, test results, history, tests,research, data, billing mechanisms, data marts, medical images,correspondence, notes, files, vital signs, real time diagnostic testingresults, images, consultation, pharmacology selection, detailing,alerts, transcription, conferencing, outcome data and research,reference and treatment options within a single screen/portal/channel.In a broader sense as shown in FIG. 6, the present invention thusprovides a comprehensive system including broadband access andconnectivity, data mining and operating software, and a fully integratedbackbone.

Referring to FIG. 3, there is shown a block diagram representation of apreferred embodiment of the present invention. From a structural andoperational standpoint, a preferred embodiment of the inventioncomprises a central computer server 50 connected by a computer network12 such as the internet to remote end user stations 16. The centralserver 50 connects to a database 40. In a preferred embodiment, the enduser stations 16 can comprise a plurality of healthcare providers andpatients linked to the computer network 12 via a transport medium 30.Preferably the central server 50 provides a website such aswww.uspreventivemed.com which can host a set of content and tools forhealth and medical applications of the invention. The website canprovide a host of database driven content related to health and wellnessincluding multimedia presentations, FAQ, articles, chatrooms andbulletin boards. A critical feature of the invention is the provision ofaudio-visual interaction between the end users 16 as well as diagnosticinteraction. Thus, home monitoring of patients during a cyber officevisit is possible.

The end user 16 as noted above, in a one preferred embodiment, can belinked via a global computer network 12 such as the Internet, intranetor worldwide web. However, but other embodiments including LANs, WANs,many different types of intranets or any other type of communicationssystem can fulfill the spirit and scope of the present invention. Enduser system 16 can be any devices that interconnect to the system via anetwork or other IP transport methods. They include, but are not limitedto, such devices as televisions, computers, hand-held devices, cellularphones, land based telephones, wireless electronic devices and anydevice which can use a transport medium such as the transport medium 30.

Non-limiting examples of a transport medium 30 applicable for use in thepresent invention can include any backbone or link such as an ATM link,FDDI link, satellite link, cable, cellular, twisted pair, fiber optic,broadcast wireless network, the internet, the worldwide web, local areanetwork (LAN), wide area network (WAN) or any other kind of intranetenvironment including a standard Ethernet link. In such alternativecases, the clients can communicate with the system using protocolsappropriate to the network to which the client is attached.

The present invention may comprise a multi server 21 environment whichcomprises a computer system in accordance with the present inventionthat allows the multiple users 16 to communicate with the system.Through communication links such as the transport medium 30 the endusers 16 can be linked to a server such as the central server 50preferably by a customizable interface to be described in greater detailbelow.

Referring to FIGS. 4 and 5, the central server and database systems ofthe present invention are shown and described in greater detail. A localdirector 23 as shown in FIG. 4 routes signals through the system to thevarious servers, to be described in more detail below, and to andthrough the transport medium 30 to the browsers 80 of the end user 16.All routing of information can be performed over virtual paths. Thesystem preferably includes two primary servers, a web server 40 and adatabase server 50 which may operate using such database platforms asSQL server or Oracle. Hence, in one embodiment the SQL server may runSQL server database management software from Microsoft Corporation.Alternatively, the server can run an Oracle database server. As notedabove, the system can also incorporate media servers.

The system further includes an administrative workstation 60 as shown inFIG. 4 or system which can provide the administrative capabilities andmonitoring for the system under the control of an administrativesubsystem 140 within the administrative work station 60. Theadministrative workstation 60 allows administrators or other operatorsto filter information and perform routine operations which affect theentire system. Such operations can include, but are not limited to,administering the accounts of, for example, healthcare providers andpatients, ordering and control of products to be sold through thewebsite, back end functions, adding or deleting new users, tabulation ofprinting reports and performing backups and maintaining the programswithin the overall system.

A web subsystem 70 as shown in both FIGS. 4, 5 can be responsible forinteractions with a web browser 80 at the locations of the end userdevices 16. The web subsystem serves as an end user interface to thesystem. Interactions between the devices 16 and the database subsystemoccur through the web subsystem 70. An Internet Information Server (IIS)200 by Microsoft Corporation is an exemplary web server which can beused as the subsystem 70 in accordance with the present invention,although the present invention is in no way limited to this system. Theexpression of the user interface presented to users 16 in their clientdevices may be implemented as HTML or any other high level computerlanguage or technology known to those skilled in the art, and may bedisplayed in a standard web browser 80 including a wireless browser 80.

All systems described herein can communicate by way of a gigabitEthernet Base T network and a switching hub. The web server 40 can sendHTML or other high level computer language to the end user work stations16, validate passwords, send logging and transaction information to thedatabase server 50 and perform logical operations, thus behaving as atransactional server.

In one embodiment, the server operating system may be a Windows NTserver, a multi-platform operating system provided by MicrosoftCorporation and can include media servers. The Sun Microsystems Solarisis one alternative embodiment. The server typically includes IIS, whichis a completely integrated internet application platform. IIS includes ahigh-performance web server, an application development environment,integrated full-text searching, multi-media streaming and sitemanagement tools. The security infrastructure is integrated within theserver, thus enabling an easy-to-maintain and highly secure webdevelopment and deployment environment.

The operators of the system may create, delete and update accountinformation utilizing the administrative subsystem 140 (as shown inFIGS. 4, 5) in the administrator work station 60. A billing subsystem100 (as shown in FIG. 4) can be responsible for credit card, debit cardor checking account verification and any other necessary billing typefunctions. Database subsystem 110, communication subsystem 120 andbilling subsystem 100 can thus execute essential services for otherparts of the system, and can therefore have well-defined applicationprogram interfaces (API) 112, 1122, 1102, as is well recognized by thosewith skill in the art. The system will preferably be protected for theinternet by a firewall 90 which is a safety precaution, and importantwith respect to the present invention due to the sensitive andconfidential nature of some of the material in the databases.

In a preferred embodiment, databases such as the database subsystem 110store pertinent information pertaining to end users 16 transactions andaccount history, as well as general dynamic system information. Allinteractions with the database subsystem are performed through adatabase API 10 which may define the interface to a library 130 ofstored procedures as shown in FIG. 5. These are used to implementhigh-level database functions and to shield the details of the databaseimplementation from the other subsystems. The database subsystem 110 ispreferably implemented using the database server 50. The databasescontain such information as user information, records, account status,the inventory of items available for sale, content, multimediapresentations and medical histories.

The administration subsystem 140 as shown in FIG. 4 provides aninterface for operators and managers of the system to modify thedatabase, print reports, view system data and log user information. Theadministration subsystem 140 provides a collection of access forms,queries, reports and modules to implement the administration interface.Administrators can typically have the power within the system to forcemost actions. The administration subsystem 140 will interact with thecommunications, database and billing subsystems.

The communications subsystem 120 is interfaced to a communications API122, for example, to notify the end users 16. Users 16 may be notifiedby telephone, fax, email or pager, or other communications devices,which can be contacted by the system 125 as shown in FIG. 4. Someportable telephones and pagers can include email addresses and so may becontacted by the email system. Other users may have only telephonenumbers. Other interfaces may be utilized as the application so demands.

A batch subsystem 125 within the communications server of FIG. 4 mayperiodically send out grouped notifications. It will access the databasesubsystem 1 10 to determine what notifications are required, and use thecommunication subsystem 120 to make the notifications. The billingsubsystem 100 may be used to verify and bill credit cards, whereapplicable, and communicate through the billing API 102 with theadministration subsystem 140. Furthermore, the billing subsystem canpotentially communicate with an outside billing and verification servicewhich could be used to perform the billing functions.

Referring to FIG. 5, the database server 50 which can implement thedatabase subsystem 110 of the present invention comprises a server thatcan maintain all associated logging and transaction information for thesystem. Through the database 40 (which can be backed up by a backupdatabase for safety purposes), the database server 50 logs user setup,account creation information, diagnostic information and tests,maintains and tabulates transactions and collections. It also hostsbackup operations and performs statistical calculations for the entiresystem.

The database server 50 is preferably a dual processor computermicroprocessor. Each connection to the database 150 and its associatedinformation may be handled by a separate thread within the databaseserver 50 processor space. It is anticipated that a dual processormachine may be sufficient for the type and amount of transactions thatit will be performed. However, if a dual processor proves insufficient,the database storage can be implemented in two or more machines todistribute the server load.

The disk subsystem 190 shown in FIG. 4 of the database server 50 maycomprise a vulnerable and crucial server element. Due to the criticaldesign of the subsystem, it is preferable to utilize a device such as aLevel 5 RAID. RAID is an alternative to standard SCSI hard disk drives.A RAID system provides automatic recovery from hard drive failures.Level 5 RAID systems provide the best balance between cost and level ofdata protection. A system such as the Level 5 RAID system can usemultiple hard disk drives on which the stored data can be recordedredundantly using a scheme by which the data on the disk can becompletely reconstructed in the event that one of the disk drive unitsin the RAID fails.

In the event of failure, the failed drive can be removed from the RAIDsystem while it is still operating and a replacement drive can beinstalled. A system such as the RAID system can regenerate the data andreturn itself to full protection capability. The data sorted on the disksubsystem remains available for normal processing, that is, from thetime the drive fails to the time the RAID system is returned to fullprotection capability. Other levels of RAID which are less costly do notoffer this type of data availability and could translate into costlysystem downtime.

In one embodiment, there can be one operator workstation 60 used foradministering the system. As the need for additional workstationsarises, additional operator workstations can be added by addingadditional computer systems, installing the administration software andconnecting them to the LAN. Operator workstation machines preferablyutilize a Windows operating environment manufactured by MicrosoftCorporation.

In view of the above operational environment, the present invention isnow described in the context of a web-based system for providing online,interactive content between any number of end users 16. In oneembodiment, the end users 16 can include a doctor and patient. In otherembodiments, the end users can comprise an attorney-client, real estatebroker-customer, or any other pair of commercial users who need toprovide content and information to each other.

By utilizing the system of the invention the end users 16 are able toquickly locate information on a desired basis. The present invention hasa number of uses and applications, including the ability to push updatedinformation to end users to send email notices and to enable users tocontinue to use the available programs when offline. This permitsproviding content and audio video formats enabling end users 16 to tracktheir own progress when using program receiving dynamic risk assessmentsand locating health-care services and providers. The system incorporatesdata storage and security for any type of sensitive information.

Many other applications are made available by the present invention.Both federal and state prisoners are required to have medical andpsychiatric care. This could be provided by the present invention.Similarly the care of military veterans could be undertaken with thepresent invention, thereby realizing significant cost savings frominformation. The present invention could be used in the areas of ruralor remote psychoanalysis. Some emergency services could also be providedin a one on one supervision environment in advance of transport orfacility treatment. Post surgical monitoring in modern nursing homes isanother medical application. Emergencies in nursing homes, monitoringand medical care could be provided by the present invention. As shown inFIG. 6, the present invention can provides a comprehensive systemincluding one on one real time audio visual supervision, broadbandaccess and connectivity, data mining, operating software and a fullyintegrated management backbone. The invention can thus provide serviceproviders and end users full time supervision through audio/videocontact for children, elderly or sick people where the audio/video canprovide a direct diagnostics tool drastically enhancing intelligencegathering during supervision.

As shown in FIG. 7, the supervision portal and data center of theinvention provides for multiple channel supervision environments usinglinked channels. In one embodiment, five different information channels,or information streams (for example, audio/video or virtual electronicrecords channels) are simultaneously available to the service providerduring supervision procedures. The channels can be distinct and can belocated at different nodes. Furthermore, the supervised integration andsynchronizing of the channels permits single portal access to all theresources made available to the system. The invention provides forselectability of audio video channels 200, in response to patient, useror institutional addresses which access records concurrently. The chartscan be charts, history, etc. A faster channel can provide supervisionand contain the audio/video streams necessary for live one on onesupervision activities, such as those involved in telemedicineapplications or other complex applications.

The second channel 202 can provide records and contain personalinformation of the patient (electronic medical records, EMRs) such ascharts, doctors' notes, portion of audio/video sessions, etc. A thirdchannel 204 can provide diagnostics and refer to specific real-timealert signals generated from tests run on medical instrumentationresults which can be compared to records information and audio/visualstreams. A fourth channel 206 can provide E-health or treatmentservices, and automatically generate prescriptions and present them to aservice provider for review and addition of a electronic signature. Itcan also interface with pharmacies and allow patients access toinformation about their treatments via a portal.

A fifth channel 208 can provide the administrative and other managementfunctions or linking functions needed for each application. Thefunctions can include patient billing and insurance filing andpurchasing. Purchasing can be another feature of the administrativechannel where inventories are matched to patients needs and orders areautomatically generated when necessary. Interfaces with hospitaladministrative systems can be transparent to the user in a preferredembodiment of the invention. FIG. 9 shows some of the information thatcan typically be transmitted within the system of the invention when itis applied to telemedicine. It will be understood that in an alternateembodiment channels two through five can also be provided withaudio/visual capability if desired.

The administrative channel 20 can also include prescription services. APalm-like or other handheld device may support a cellular phone and WLANconnections to the system and the patient. In an example, a doctor maywrite a prescription. The system could automatically send theprescription for pre-authorization to an insurance companysimultaneously. The patient can pay the normal co-payment to theinsurance company. The handheld device may be used by the doctor's stuffto update the patient's electronic medical records in real time.

Thus, the invention can provide structured intelligence gathering fromunstructured multichannel audio/video streams. The invention can becharacterized by a number of features including multiple audio/videoconferencing channels electronic medical records or generalpurpose-electronic records, the use of intelligent diagnostics andalerting tools and the incorporation of a portal which links tools andembeds technologies.

The invention can provide the means to interpret audio/video informationthus opening up an unlimited number of applications. The inventionbuilds intelligence from basic and massive information gathering andallows constant audio/video transmission and the simultaneous operationof store forward and real time audio/video in a single channel. Theinvention can also provide the progressive resolution control forselected elements in the audio/video stream within limited bandwidthsystems.

The invention can provide for the full time supervision of children, theelderly, those requiring medical treatment and monitoring for security,medical and insurance purposes, etc. The invention incorporates medicalinstrumentation, survey and sensing equipment and measurementinstrumentation of different types. The instrumentation can besupplemented with audio/video readings. It provides for 3-Dvisualization or wear-on pieces (bracelets, rings, helmet) foraudio/visual supervision of patients. Voice to text translation andvoice commands for the creation of time marks in the continuoussupervision audio/video stream are provided in a preferred embodiment.

The system can monitor the ingestion of solids or liquids by an end userpatient for internal physiological measurements. It can facilitate thereading of measuring instruments attached to the body of the supervisedindividual (be it living organisms, a machine, or a non-living entity).It further facilitates temperature and infrared visual and tomographymeasurements.

Another feature of the invention is the incorporation of multi channelintelligence and diagnostics with an intelligence engine, neural netmatching and forward chaining expert systems. In this way the inventionis applicable to or can link to multiple industries using equipmentfound in any corporation. Furthermore, the applications which can beadvantageously used with the invention include treatment programs,guidelines, notes, orders, protocols, images, diagnostic data, consultsources, research information, outcomes, pharmacology data inserts,contraindications, clinical history, studies, papers, news, clinicaldata in geriatric, chronic, fitness, wellness, radiology, cardiology,psychology, human resource interview, training, educational, prisons,hospitals, clinics, treatment centers, elder care facilities, nursingfacilities, rural tele-health, teleconferencing, live examination ofpatients, assessment, diagnosis and various treatment programapplications.

The above can translate to the following three-stage functionality: (1)information, that is the pervasiveness of information, throughmultichannel availability and gradual implementation of technologiescapable of extracting and structuring information from multiplenon-structured audio/video data streams, (2) analysis of data andinformation by the healthcare professional and (3) response, throughhyper annotation and linking between audio/video data and structureddatabase records information and through real time response throughdiagnosis and alerting features. Other business implementations mayfollow architectural models such as the following: various telemedicineand videoconferencing implementations and internet corporate portalarchitectures.

Referring now to FIG. 8, there is shown the supervision portal 250 forsecure, real time interaction supervision. The supervision portal 250can involve many of the key elements considered in the definition of aninternet portal providing the functionality to support user's needs.

Any number of web browsers 254 can be coupled to the application servers264 of the supervision portal 250 by way of the web servers 260. Brokerscan be used to link the web browsers 260 to the application servers 264.In order to provide security encryption services 256 can be provided fortransmitting information from the web browsers 254 to the web browsers260.

In addition to its own information repository, the application servers264 can have access to a data warehouse 268 and OLAP store 270 which canbe coupled to the supervision content center 274. The supervisioncontent center 274, as well as the entire supervisory web services, canbe attached to any portal that may be available. Additionally, othersupervision intelligence engines 278 may be provided for the applicationservers 264 as needed. The application servers 264 can access theaudio/video, graphics and voice activation 280 by way of the supervisionand intelligence engines within the applications servers 264. The screenfunctionality capability of the system of the present invention can alsoreside within block 280.

A preferred technical architecture is one wherein the following elementsare considered as services and can be integrated in a comprehensivedistributed object architecture. One such element is the integration ofinformation to feed an individual's desktop computer. The preferredportal is adapted to filter the information to meet the individual'swork style and content preferences, ranging from the look of the desktopto where items are displayed. Filtering and profiling capabilities arealso provided. The preferred portal further provides profiling to enablethe user to continuously update his or her profile based on currentinterest so that relevant information can be retrieved on an on goingbasis.

The preferred portal will permit collaboration and project style workingforums for interactions among patients, doctors, lawyers, clients,suppliers, employees, customers, partners, etc. Groupware functionalitycan permit calendaring, project contributions, project management, workscheduling, chat, etc. It can enable participation in electronicprocesses.through the interaction of workflow at different entry andexit points. It can also enable the publication and distribution ofcontent creation, inclusion and distribution, thus approving what ismade available to the portal through workflow processes. It can alsoinclude a search function and calendaring and event based reminderstriggered by events to help manage increasing workloads,responsibilities and control processes. Finally, it can permitadministration and management of the portal environment that the portalmeets acceptable performance criteria, for example, time-based usagebilling.

The system can include substantial document storage libraries andarchitecture storing supervision data, such as data directed to healthrelated applications, integration of existing hospital, insurance, HMO,industry, government, image delivery, storage. The supervision data canalso be directed to mega data systems and software data systems in acommon data archive.

In operation, users accessing the services provided by the presentinvention can utilize web browsers such as Microsoft's Internet Exploreror Time Warner-AOL's Netscape Navigator or any other browsers known tothose skilled in the art. High-speed lines are desirable but notnecessary. The system can use encryption, thus offering secure sessionsfor patient or client confidentiality. Application servers 264 can hostthe information repository and the publish/subscribe engine, thecrawler/filter engine and the supervision intelligence engine. Theinvention can offer filtered and managed access to information containedin the internet, plus proprietary data warehouses and the supervisioncontent center 274. A supervision intelligence engine within theapplications servers 264 can offer several of the unique facilitiesprovided such as one on one audio/video, 3D visualization graphics andvoice activation capability in connection with block 280. Specificscreen functionalities features can also be provided. Document storagelibraries can be used gather information specific to the five channelsdiscussed above.

In substance then, the invention comprises a plurality of internetportal building tools which link to embedded, intelligent diagnosticsand alerting tools. For example, artificial intelligence, neural nets,forward chaining-expert systems, technologies for structuringconferencing, records and intelligence can be provided within theinternet portal architecture.

The foregoing can include multiple audio/video conferencing channels forapplications such as telemedicine, one-on-one, collaborative,multi-channel applications supporting transport of audio/video withmultiple audio/video and content frame windows, interactive liveaudio/video communication and one-on-one supervision. Such supervisioncan be based on industry standards combining store and forward tags withreal time audio/video. Such supervision can be containing informationcorresponding to live motion and still images, medical instrumentationsupport integrating medical digital examination and vital signs fromselected devices in real time. Furthermore, substantial storagecapability provides access to a large volume of stored information.

The service provider, such as a health care provider or a businessservice provider, can have single screen access to patients/subjectswhile combining evaluations, monitoring virtual medical records (VMRs),diagnostic tools, pharmacology, research, statistical outcome analysis,treatment protocols, history and options, medical test results,e-commerce and content.

With reference to FIGS. 12A-B it can be seen that information may bestructured in many ways. For example, store and forward capability canbe provided. This can be accomplished using XML. Grid (spreadsheet) orrecord (database)-based presentation of data, comprehendingquantitative, text based or static image information can also beavailable. Real time audio and video (low latency, high QoS threshold)based on existing and future Internet II standards are within thecontemplated scope of the invention.

For example, for health-industry applications electronic medical recordsare the basic structure of the invention's information for storing thepatient's medical history, current treatments, medications, insurance.The results of patient visits including laboratory test results, thephysician's diagnosis, medications prescribed, treatments administered,the patient's billing and payment and scheduling records can be also bestored.

The abundance of information in a multi-channel environment as set forthherein can require real-time response. Thus, intelligent aids such as analerting tool are provided. The alerting tool for real time patientmonitoring can be based on knowledge systems comprising sickness symptomlists with quickly variable levels of responsiveness through fuzzylogic.

Medical annotations can be coded stored and recalled. Annotations may bevoice activated and then recorded and converted to text. They can beconverted to a compressed symbolic representation particularly suitablefor immediate analysis for medical diagnosis and treatment.

The core portal of the present invention may be described as based on amerger of web conferencing and the web based ASP Group Ware. Theinvention allows service providers and end users to work together as agroup, their main goal being to remotely provide services, such ashealth services, sharing information, such as information stored inselected EMRs, and even storing selected excerpts from audio/videointeraction in EMRs. This is indeed a full Group Ware systemapplication. The invention thus brings standardization to the medical orlegal industry or to business conferencing, pulling together currentlyseparate efforts by leading corporations and finally generatingmomentum.

Other attributes are useful for achieving the foregoing goals:

(1) completeness—pervasiveness of information, through multichannelaudio/video availability,

(2) structure—structure allowing analysis and response, through hyperannotation and linking between channels and

(3) real time—real time response on that structure through diagnosis andfeatures.

Supervision web services can require a standardized way of integratingand supervising web based services. For example, the web services can beintegrated using XML, SOAP, WSDL and UDDI standards over an internetprotocol backbone. XML-Tag data, SOAP-Transfer of data, WSDL-descriptionof the services available and a UDDI-listing of the services that areavailable should also be provided in order to provide standardization.

Programmatic interfacing can provide the foregoing required integrationof web based applications. Provision web service interfacing withprivate supervision internet is a preferred way to accomplish this. Itwould be understood that the supervision of the application of theinvention interfaces services, not users. It can then add thesupervision web service to a GUI such as a web page or executableprogram to offer specific supervision functionality. The inventionsupervision services will allow different applications from differentsources to communicate with each other without time consuming customprogramming using, in the preferred embodiment, a single password. Thesupervision services are not tied to any one operating system orprogramming language.

The API application program interface of the invention includes a set ofroutines, protocols and tools for building software supervisionapplications. This facilitates a development of a supervision program byproviding all the necessary building blocks and assembling all theblocks for supervision of the teleconference. All programs can use acommon API having a standard interface, thereby facilitating theoperations for the end users.

An API for Microsoft's internet information server can be used as a webserver. This enables programmers to develop web based supervisionapplications that run faster than conventional CGI programs because theyare more tightly integrated with the web server. In addition to theinternet information web server, any other web server from othercompanies than can be used.

Many of the elements required to practice the system and method of theinvention are known to those skilled in the art. For example, theservlets useful for practicing the invention are known. A servlet is asmall program that runs on a server. This refers to a JAVA applet thatruns within a web server environment. Java applets are persistent. Theyremain in memory and can support multiple requests. Graphical userinterfaces (GUI) make it easier to move data from one application toanother. A GUI can have standard formats for representing text andgraphs. Because the formats are so well defined different programs thatrun under a common GUI can share data. While Java can be used in apreferred embodiment, it will be understood that any programminglanguage known to those skilled in the art can be used.

With reference to FIGS. 9 and 10, it will be understood that objectorientated programming is used by programmers to define not only thedata type of a data structure but also the types of operations(functions) that can be applied to the data structure. In this way thedata structure becomes the object that includes both data and function.In addition programmers can create relationships between one object andanother. Furthermore, they can define the channel supervisionapplication architecture. Thus, a one on one real time audio visualinteractive supervision application according to the invention caninclude the interactive use of virtual electronic records, devicesremote monitoring and diagnostics, treatment services and administrativefunctionality within a multi channel seamless, secure, integratednetwork.

The prime focus of the network is to provide a supervision applicationto be used as a standard. Furthermore, the network is a supervisionapplication fora private enterprise intranet. It can provide a standardsupervision application to the internet and wireless. The network canshare business logic, data and processes through a programmaticinterface across a network. It can then add the supervision web serviceto a GUI, which can be a web page or executable program to offersupervision web services to end users. The multi channel supervision webservice can enable end users to work together with ease and enable endusers to participate in decisions through the supervision web service.It can also provide white board technology for ultimate supervision orconsultation.

Users, alerts, annotations, maintenance and administrative aresynchronized within the system of the invention. This can insureconnectivity, intranet performance monitoring and management, centralbackup, directory services single sign on, access firewall protectionand agent control. The programs of the network, which can be referred toas agents, can run in servers, switches, routers and special monitoringtools distributed in widely separated locations around intranet.

Simple network management protocol (SNMP) can set the standard formanagement operations and reporting. Under the SNMP each agent monitorsits channels and gathers statistical information in a format managementinformation base. Programs are polled on a regular basis for real timeautomatic records, inventory management, medication supplies,compliance, guidelines, chronic disease management and prevention.

Patients can be monitored at home and in affiliated hospitals with oneof the multiple channels provided. Parameters that can be monitored caninclude weight, BP, HR, EKG, PO2 and temperature. The results can befaxed to general practitioners or specialists. Alerts can be issued byway of telephones. Remote devices in other channels can be reset onturned on and off.

Additionally, the system of the invention can share security issuesstill using a single sign on, GUI, servers, databases, central storage,channel supervision applications, backup, wireless network, anddirectories. The previously described multiple channels LAN can beintegrated into the WAN intranet automatically with a single log onscript.

A single log on from any computer can include authenticationidentification, encryption and a certification firewall to verify usersto the directory server and to verify the directory server interface theend user to supervision resources automatically. A smart card can beprovided for triggering a password requirement such as a facialscanning, at other locations such as pharmacy stations or localizedfixed or mobile stations in the field, behind lines or in a hospital.

A unique signature key and encryption can be provided for permittingaccess. Key pairs in the form of a certificate can include the end usersname. The certificate can contain a private key to establish authority.The certificate can pass to a directory that tracks the certified endusers and their entitlements with access to specified resources. Forexample, a user can be entitled to some but not all of the channels.

When the agents reply within the system and method of the invention aSNMP console program can aggregate the information and present itgraphically within the multiple channel supervision application format.Agents can provide content for synchronization, intelligent variablecompression, browsing video environment, alerts, annotations, real timeupgrades, billing, data mining, CDM and prevention.

Preferably the central server, as shown in FIG. 11, can contain storageand backup redundant equipment as well as high quality management forcentralized control of the supervision web service which describes astandardized way of integrating web based applications XML, SOAP, WSDLand UDDI open standards over a intranet protocol backbone can be used.The central server programs allow LAN or channel functionality to beaccessed synchronized to the patient. All end users can obtain access tothe intranet through a single firewall which provides protected highspeed access. A central router device routes and prioritizes traffic ona corporate intranet. LAN's are thereby linked with routers and agents.Ethernet switches can provide access to specific ports on the centralserver to avoid congestion. All of the devices on the WAN intranet canhave a unique IP address. NAT uses special non-routable IP addressesthat are reserved for a private intranet.

The network architecture of the invention can eliminate many problems.For example, latency, low bandwidth and network outages can beeliminated using the system and method of the invention. The system cancommunicate with as many separate systems as required. The efficiency ofthe system permits it to handle multiple requests at one time withoutbeing overloaded. The central control can permit intranet management andautomatic updating in real time by the system and method of theinvention. Cellular telephone technology can allow the system to usemicrowave and satellite technology. Furthermore, a hybrid system can useboth wireless and wired services, e.g. the WIFI Ethernet 802.11.

Referring now to FIGS. 10A, B there are shown block diagramrepresentations of the graphical user interface 290 and a control centerserver 295 that can be used with the system of the present invention.The single display of the information transmitted by way of all fivechannels can be made available to the end users 16, 18 simultaneously onthe graphical user interface 290 to provide the supervision web servicesto the end users 16, 18. As shown in FIG. 10A each channel can bedisplayed simultaneously on a selected area of the graphical userinterface 290 for viewing by the medical worker or other supervisor enduser. Other end users may only receive selected ones of the fivedisplays shown in graphical user interface 290.

The control center server 295 can be used to synchronize the informationin the five channels to the particular patient which is identified tothe system by the service provider or the client. This permits access tothe information of all five channels with a single password forauthorized end users. It serves as a direct single sign on wherein thesystem programs, known as agents, synthesize and synchronize theinformation on the five channels. This also permits annotation andstorage of the information in all five channels in real time and makesthe entire teleconference available for review at a later time.

Referring now to FIG. 11, there is shown a block diagram representationof an intranet connection 300 which can be used within the system andmethod of the present invention. In the intranet connection 300, thehigh speed access devices 320 include a plurality of LANs, which canhave their own routers and agents for transmitting the information ofthe five channels to the control center server 295. A plurality ofswitches is provided in cooperation with the control center server 295for performing the previously mentioned integration and synchronizationof the information from the five channels of the high speed accessdevice 320. A router 312 can route the information to any number ofgraphical user interfaces 290 for display to the end users 16, 18 by wayof the signal firewall 304.

Referring now to FIGS. 12A-C, there are shown enterprise intranetconnections 330 which may be used with the system of the presentinvention including the GUI 290, 295, 302 wherein the five applicationschannels can be mapped onto the display as shown. In the enterpriseintranet connection 330 LANs are coupled to the server 295 by aprogrammatic interface 335, wherein the LANs are understood to representapplications being communicated by way of the application channels. Thispermits the supervision web service of the present invention to sharebusiness logic, data and processes through the programmatic interface335. The supervision web service of the invention can be transmitted tothe correct channel locations on the graphical user interface 290, 295,302 as shown in the drawings by the programmatic interface 335, anddisplayed to the end users 16, 18 as previously described.

Referring now to FIG. 13, there is shown an intranet connection 340. Theintranet connection 340 permits a large integration effort for sharingthe resources available in the LANs. The supervisory web services canshare security issues, GUIs databases, central storage, five channelsupervision, web service and applications, As previously described abackup RAID 345 can be coupled to the control center server 295 withinthe WAN 350.

Referring now to FIG. 14, there is shown a certificate authority processwhich can be used with the system and method of the present invention.In the certificate authority process 355 the end users are provided witha unique key and encryption to provide certificate 370. The directoryserver 380 determines whether the parties seeking access to the systemare entitled to access to the requested channels. The directory server380 can perform this operation with the authentication server 390 andthe application server 400.

Thus, in one preferred embodiment of the invention the supervisory webserver can: (1) work with a private enterprise intranet for supervisionof web services, (2) have a control center server containing storage,backup of all channels and recording of all channels with redundantequipment for centralized control of the supervisory web service, (3)describe a standardized way of integrating web based supervisionapplications using XML, SOAP, WSOL, UDDI, CORBA, DCOM, DSOM openstandards over an intranet protocol backbone, (4) include a centralserver program which serves as a programmatic interface and allows LANor channel functionality in web based applications to be accessed andsynchronized to patient, (5) permit end users to access the intranetthrough a single firewall which provides protected high speed access andpermits one sign on only for the entire web based supervisoryapplication, (6) include a central router device which routes andprioritizes traffic on a corporate intranet, (7) link LAN servers withrouters and agents, (8) provide ethernet switching to specific ports onthe control center server, (9) provide all devices with a unique IPaddress wherein NAT (National Address Translation) uses special nonroutable IP addresses that are reserved for a private intranet, (10)provide network architecture that eliminates problems such as externalproblems, latency, low bandwidth and network outages, (11) communicatewith as many different systems as possible using any JAVA enabledmachine or any other system known to those skilled in the art, (12)provide an efficient way to handle multiple requests at once withoutgetting bogged down, (13) provide any of the five channels (supervisionweb based applications) desired by the end user as displayed by the GUI,(14) provide a central control center that includes intranet management,(15) automate updating in real time, (16) use cellular telephonetechnology with microwave and satellite telecommunication by providinghybrid bridges and wireless and wired networks, (17) use WIFI andethernet 802 standards, (18) link through Bluetooth, (19) provide WPA(WIFI Protected Access) and (20) authenticate using TKIP (Temporal KeyIntegrity Protocol).

The present invention has been described with references to the enclosedfigures and description. It is to be appreciated that the true spiritand scope of the invention is to be determined with reference to theattached claims.

1. A method for providing supervision to a teleconference including aservice provider and a user, comprising: providing a plurality ofinformation channels for communicating information to said serviceprovider and said user; and integrating the information channels of saidplurality of information channels to provide access to supervisoryfunctionality for supervising said information channels of saidplurality of information channels by way of a single portal.
 2. Themethod for providing supervision to a teleconference including a serviceprovider and a user of claim 1, wherein said single portal comprises acustomized graphical user interface for providing supervisionapplications for a service provider.
 3. The method for providingsupervision to a teleconference including a service provider and a userof claim 1, wherein said integrated channels provide a virtual officevisit.
 4. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 1, further comprisingproviding access to audio/visual functionality by way of said singleportal.
 5. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 4, further comprisingproviding access to information record functionality by way of saidsingle portal.
 6. The method for providing supervision to ateleconference including a service provider and a user of claim 5,further comprising providing access to diagnostic functionality by wayof said portal.
 7. The method for providing supervision to ateleconference including a service provider and a user of claim 6,further comprising providing access to action functionality by way ofsaid portal.
 8. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 7, further comprisingproviding access to administrative functionality by way of said portalwhereby said portal has access to said functionalities simultaneously.9. The method for providing supervision to a teleconference including aservice provider and a user of claim 8, further comprising singleaccessing of said portal by said user whereby said user gains access toall of said functionalities simultaneously in accordance with saidsingle accessing.
 10. The method for providing supervision to ateleconference including a service provider and a user of claim 8,wherein said portal comprises a web portal.
 11. The method for providingsupervision to a teleconference including a service provider and a userof claim 8, further comprising accessing each of said functionalities byway of a respective information channel of a plurality of informationchannels.
 12. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 11, wherein at leastone of said respective information channels comprises a plurality ofinformation channels.
 13. The method for providing supervision to ateleconference including a service provider and a user of claim 11,further comprising selecting an information channel of said plurality ofinformation channels for accessing a selected functionality.
 14. Themethod for providing supervision to a teleconference including a serviceprovider and a user of claim 8, wherein at least one of said respectivechannels is an audio/visual channel.
 15. The method for providingsupervision to a teleconference including a service provider and a userof claim 8, wherein said supervisory functionality comprises supervisionof medical functionality.
 16. The method for providing supervision to ateleconference including a service provider and a user of claim 15,wherein said record information functionality comprises accessingmedical records information.
 17. The method for providing supervision toa teleconference including a service provider and a user of claim 16,wherein said diagnostic functionality comprises monitoring at least onemedical parameter to provide a monitored medical parameter.
 18. Themethod for providing supervision to a teleconference including a serviceprovider and a user of claim 17, further comprising providing an alertin accordance with said monitored medical parameter.
 19. The method forproviding supervision to a teleconference including a service providerand a user of claim 17, wherein said action functionality comprisesproviding a prescription in accordance with said monitored medicalparameter.
 20. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 15, wherein saidadministrative functionality comprises providing a bill to said user.21. The method for providing supervision to a teleconference including aservice provider and a user of claim 15, wherein said supervisoryfunctionality comprises sending group ware including facsimiles andemail.
 22. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 1, wherein saidsupervisory functionality comprises supervision of legal functionality.23. The method for providing supervision to a teleconference including aservice provider and a user of claim 8, further comprising displayingaccess to all of said functionalities simultaneously on a single webpage.
 24. A system for providing supervision to a teleconferenceincluding a service provider and a user, comprising a portalsimultaneously having access to audio/visual functionality, informationrecord functionality, diagnostic functionality, action functionality andadministrative functionality.
 25. The system for providing supervisionto a teleconference including a service provider and a user of claim 24,further comprising a single access of said portal by said user wherebysaid user gains access to all of said functionalities simultaneously inaccordance with said single access.
 26. The system for providingsupervision to a teleconference including a service provider and a userof claim 25, wherein said single access comprises a single access inaccordance with a single sign in.
 27. The system for providingsupervision to a teleconference including a service provider and a userof claim 24, wherein said portal comprises a web portal.
 28. The systemfor providing supervision to a teleconference including a serviceprovider and a user of claim 24, wherein each of said functionalities isaccessed by way of a respective information channel of a plurality ofinformation channels.
 29. The system for providing supervision to ateleconference including a service provider and a user of claim 27,wherein at least one of said respective information channels comprises aplurality of information channels.
 30. The system for providingsupervision to a teleconference including a service provider and a userof claim 28, further comprising a selected information channel of saidplurality of information channels for accessing a selectedfunctionality.
 31. The system for providing supervision to ateleconference including a service provider and a user of claim 24,wherein said supervision comprises supervision of medical functionality.32. The system for providing supervision to a teleconference including aservice provider and a user of claim 31, wherein said record informationfunctionality comprises accessing medical records information.
 33. Thesystem for providing supervision to a teleconference including a serviceprovider and a user of claim 32, wherein said diagnostic functionalitycomprises monitoring at least one medical parameter.
 34. The system forproviding supervision to a teleconference including a service providerand a user of claim 24, wherein said supervision comprises supervisionof legal functionality.
 35. The system for providing supervision to ateleconference including a service provider and a user of claim 24,further comprising a graphical user interface displaying the informationof all of said functionalities simultaneously on a single web page. 36.A method for providing supervision to a teleconference including aservice provider and a user, comprising: providing access toaudio/visual functionality by way of a portal; providing access toinformation record functionality by way of said web portal; providingaccess to diagnostic functionality by way of said portal; providingaccess to action functionality by way of said portal; and providingaccess to administrative functionality by way of said portal whereinsaid portal has access to said functionalities simultaneously in orderto provide supervision of said functionalities.
 37. The method forproviding supervision to a teleconference including a service providerand a user of claim 36, further comprising single accessing of saidportal by said user whereby said user gains access to all of saidfunctionalities simultaneously in accordance with said single accessing.38. The method for providing supervision to a teleconference including aservice provider and a user of claim 36, wherein said portal comprises aweb portal.
 39. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 36, further comprisingaccessing each of said functionalities by way of a respectiveinformation channel.
 40. The method for providing supervision to ateleconference including a service provider and a user of claim 39,wherein at least one of said respective channels comprises a pluralityof information channels.
 41. The method for providing supervision to ateleconference including a service provider and a user of claim 40,wherein said portal comprises a web portal.
 42. The method for providingsupervision to a teleconference including a service provider and a userof claim 39, further comprising selecting an information channel of saidplurality of information channels for accessing a selectedfunctionality.
 43. The method for providing supervision to ateleconference including a service provider and a user of claim 37,wherein said supervision comprises supervision of medical functionality.44. The method for providing supervision to a teleconference including aservice provider and a user of claim 43, wherein said record informationfunctionality comprises accessing medical records information.
 45. Themethod for providing supervision to a teleconference including a serviceprovider and a user of claim 44, wherein said diagnostic functionalitycomprises monitoring at least one medical parameter to provide amonitored medical parameter.
 46. The method for providing supervision toa teleconference including a service provider and a user of claim 36,wherein said supervision comprises supervision of legal functionality.47. The method for providing supervision to a teleconference including aservice provider and a user of claim 36, further comprising displayingaccess to all of said functionalities simultaneously on a single webpage.
 48. The method for providing supervision to a teleconferenceincluding a service provider and a user of claim 36, further comprisingsynchronizing said functionalities to said user.
 49. The method forproviding supervision to a teleconference including a service providerand a user of claim 36, wherein each of said functionalities is providedwith a unique IP address.
 50. The method for providing supervision to ateleconference including a service provider and a user of claim 2,further comprising viewing information of all information channels ofsaid plurality of information channels synchronized simultaneously tosaid user in real time by way of said graphical user interface.
 51. Themethod for providing supervision to a teleconference including a serviceprovider and a user of claim 5, wherein records accessed by way of saidsingle portal are available to said service provider at a centrallocation during an office visit in real time.
 52. The method forproviding supervision to a teleconference including a service providerand a user of claim 5, wherein said information record functionalitycomprises accessing redundantly stored data.
 53. The method forproviding supervision to a teleconference including a service providerand a user of claim 52, wherein said redundantly stored data is storedin a RAID system.
 54. The system for providing supervision to ateleconference including a service provider and a user of claim 38,further comprising a view of all information channels synchronizedsimultaneously to said user in real time by way of a graphical userinterface.
 55. A method for providing supervision to a teleconferenceincluding a service provider and a user of claim 36, wherein saidinformation record functionality comprises records available to saidservice provider at a central location during a virtual office visit inreal time.
 56. The system for providing supervision to a teleconferenceincluding a service provider and a user of claim 36, wherein saidinformation record functionality comprises redundantly stored data in aRAID system.
 57. The system for providing supervision to ateleconference including a service provider and a user of claim 24,further comprising a graphical user interface for viewing all of saidfunctionalities synchronized simultaneously to said user in real time byway of said graphical user interface.
 58. The system for providingsupervision to a teleconference including a service provider and a userof claim 32, wherein a central storage location for storing the recordsof said information record functionality.
 59. The system for providingsupervision to a teleconference including a service provider and a userof claim 58, wherein said information record functionality comprises acentral data base for redundantly storing records in a RAID system. 60.The method for providing supervision to a teleconference including aservice provider and a user of claim 50, further comprising combiningall information channels of said plurality of information channels byway of a programmatic interface for applying combined channels to saidgraphical user interface.